Annals of Case Reports (ISSN: 2574-7754)

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Unusual Presentation of Metastatic Breast Cancer; Dyspeptic Complaints (A Case Report)

Mustafa Denizli1*, Selnur Özkurt4, Aysel Bayram2, Melek Büyük2, Melin  Aydan Ahmed3, Seden Küçücük4

1Istanbul University Istanbul Faculty of Medicine, Radiation Oncology, Turkey

2Istanbul University Istanbul Faculty of Medicine, Pathology, Turkey

3Istanbul University Istanbul Faculty of Medicine, Medical Oncology, Turkey

4Istanbul University Institute of Oncology, Radiation Oncology, Turkey

*Corresponding author: Mustafa Denizli, Istanbul University Istanbul Faculty of Medicine, Radiation Oncology, Turkey

Received Date: 01 January 2023

Accepted Date: 06 January 2023

Published Date: 09 January 2023

Citation: Denizli M, Özkurt S, Bayram A, Büyük M, Ahmed MA, et al. (2023) Unusual Presentation of Metastatic Breast Cancer; Dyspeptic Complaints (A Case Report). Ann Case Report 08: 1121. DOI: https://doi.org/10.29011/2574-7754.101121

Introduction

It is uncommon for breast cancer to metastasize to the gastrointestinal tract, and the colon and rectum are the most typical locations, followed by the stomach. Gastric metastasis most common primary source is breast cancer. Gastric metastases are usually disregarded in individuals with dyspeptic symptoms because they frequently undergo symptomatic medications or are treated for it as a side effect of cancer treatment. Endoscopic evaluations are important at this stage. The development of linitis plastica, a frequent gastroscopy finding, makes the diagnosis susceptible to error if deep and numerous biopsies are not performed. In this case, a patient without a history of cancer is presented. During test for dyspeptic complaints, the patient’s breast cancer metastasis to the stomach was diagnosed

Case Report

70 years old patient with no personal or family history, in November 2021, when she visited to the Internal Medicine Department with complaints of nausea and loss of appetite, a suspicious lesion in the corpus was observed in the esophagogastro-duodenoscopy and biopsy was taken.

Upon detection of acinar and trabecular tumoral infiltration in the biopsy specimen, advanced immunohistochemically staining was performed and the result was reported as invasive lobular carcinoma metastasis of the breast. Then in the breast Ultrasonography (USG) a possible malignant lesion with lobulated contours in the upper middle part of the left breast and multiple, conglomerated pathological lymph nodes in the left axilla and left subclavian region were detected. In addition to these findings, breast MR imaging revealed band-like satellite tumoral lesions in the upper and lower outer quadrants of the left breast.

Figure 1: Breast MRI.
Invasive lobular carcinoma was found after the true-cut biopsy of the patient’s left upper middle breast. (ER: +, PR:-, HER-2:-, Ki67:13%).

PET/CT scan was performed for systemic staging and pathological uptakes in the area corresponding to the lesion identified in breast MRI; metastatic conglomerated lymph nodes filling the left axilla and extending into subpectoral space; a metastatic increase in gastric corpus wall thickness; metastatic lymph nodes in the left internal iliac, bilateral common iliac and paraaortocaval areas; 2 cm metastatic involvement on the right of the cerebellum; multiple lytic metastasis in the skeletal system has been reported.